Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
  • A61L31/04—Macromolecular materials
  • A61L31/043—Proteins; Polypeptides; Degradation products thereof
  • A61L31/044—Collagen
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/0063—Implantable repair or support meshes, e.g. hernia meshes
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
  • A61L31/005—Ingredients of undetermined constitution or reaction products thereof
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/0063—Implantable repair or support meshes, e.g. hernia meshes
  • A61F2002/0068—Implantable repair or support meshes, e.g. hernia meshes having a special mesh pattern
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L2430/00—Materials or treatment for tissue regeneration
  • A61L2430/40—Preparation and treatment of biological tissue for implantation, e.g. decellularisation, cross-linking

Definitions

• the present disclosure relates to methods of stabilizing collagen- containing extracellular tissue matrices against enzymatic degradation by
• the present disclosure also relates to crosslinked collagen-containing extracellular tissue matrices produced by such methods, as well as to tissue products produced from such matrices.
• Collagen-containing tissue products are frequently used to regenerate, repair, augment, or otherwise treat diseased or damaged tissues and organs.
• these tissue products When implanted in or on a patient or animal, these tissue products are subject to enzymatic degradation over time, disrupting the collagen and/or other proteins and causing a decrease in or change in various mechanical properties ⁇ e.g., breaking load, strength, elasticity, suture retention strength, stiffness, etc.) of the tissue product.
• Some mechanical properties of collagen-based materials can be increased by the incorporation of intermolecular crosslinks.
• cross-linking can reduce the enzymatic susceptibility to some enzymes.
• collagen- containing tissue can be stabilized against enzymatic degradation, and the concomitant decrease in mechanical properties, through crosslinking.
• Collagen can be crosslinked via chemical methods, such as through the use of chemical crosslinkers containing aldehyde, isocyanate, and/or carbodiimide functionalities. However, the use of chemical crosslinkers may raise biocompatibiiity concerns.
• collagen-containing tissue can be crosslinked via irradiation, e.g., with ultraviolet (UV) light.
• Crosslinking with UV light is rapid and effective and has no associated risk of induced cytotoxicity.
• UV light becomes highly attenuated as it crosses the collagen-containing tissue matrix due to its naturally wet condition, as well as by the presence of any added crosslinking agents, such as riboflavin.
• the thickness of the matrix increases, the weaker the penetration of UV light into the deeper portions of the matrix.
• the use of UV light has so far been ineffective for crosslinking collagen-based matrices having a thickness of greater than 200 ⁇ .
• a method for producing a crosslinked tissue matrix comprising the steps of (1 ) dehydrating a collagen-containing tissue matrix to form a dehydrated collagen- containing tissue matrix and (2) irradiating the dehydrated collagen-containing tissue matrix with UV light such that at least a portion of the dehydrated collagen-containing tissue matrix is crosslinked.
• the collagen-containing tissue matrix is an acellular tissue matrix.
• the collagen-containing tissue matrix is a dermal tissue matrix.
• the collagen- containing tissue matrix is derived from a tissue selected from the group consisting of fascia, muscle (smooth, cardiac, or striated), pericardial tissue, dura, umbilical cord tissue, placental tissue, cardiac valve tissue, ligament tissue, tendon tissue, arterial tissue, venous tissue, neural connective tissue, urinary bladder tissue, ureter tissue, and intestinal tissue.
• the method further comprises impregnating the collagen-containing tissue matrix with a photo-activated crosslinker prior to step (1 ).
• the photo-activated crosslinker is riboflavin-5'-phosphate.
• the collagen-containing tissue matrix is impregnated with riboflavin-5'-phosphate by soaking it in an aqueous solution comprising riboflavin-5'-phosphate.
• the aqueous solution comprises from 0.1 to 1 .0 % of riboflavin-5'-phosphate.
• the aqueous solution is a phosphate-buffered saline solution.
• the method further comprises the step of (3) rehydrating the crosslinked collagen-containing tissue matrix.
• the UV light is UV-A light.
• the UV-A light has a wavelength of approximately 370 nm.
• the collagen-containing tissue matrix has a thickness of greater than 200 ⁇ . In certain embodiments, the collagen-containing tissue matrix has a thickness of 800 ⁇ or greater.
• the collagen-containing tissue matrix is dehydrated via vacuum drying, air drying, or treatment with an inert gas.
• the entire dehydrated collagen-containing tissue matrix is irradiated with UV light.
• one or more select regions of the collagen-containing tissue matrix is irradiated with UV light.
• an array of lines and/or spots on the collagen-containing tissue matrix is irradiated with UV light through a mask.
• the collagen-containing tissue matrix is irradiated with UV light such that a pattern of cross-linked collagen-containing tissue matrix is obtained.
• the pattern is selected from the group consisting of serpentine patterns, web-like patterns, circular patterns, grid patterns, linear patterns, and combinations thereof.
• a crosslinked tissue matrix produced by the above method is provided.
• the crosslinked tissue matrix is in the form of a sheet.
• tissue product comprising the above crosslinked tissue matrix.
• the tissue product is a hernia repair mesh.
• tissue product comprising an acellular, collagen-containing tissue matrix.
• the tissue matrix can be a flexible sheet having a thickness of greater than 200 ⁇ , wherein the tissue matrix is cross-linked to a depth of greater than 200 ⁇ from a surface of the tissue matrix, and wherein the tissue matrix is free of cytotoxic residues.
• the collagen-containing tissue matrix is a dermal tissue matrix.
• the collagen-containing tissue matrix is derived from a tissue selected from the group consisting of fascia, muscle (striated, smooth, or cardiac), pericardial tissue, dura, umbilical cord tissue, placental tissue, cardiac valve tissue, ligament tissue, tendon tissue, arterial tissue, venous tissue, neural connective tissue, urinary bladder tissue, ureter tissue, and intestinal tissue.
• the tissue matrix is cross-linked across the full thickness of the tissue matrix.
• the collagen-containing tissue matrix has a thickness of 800 ⁇ or greater.
• the collagen-containing tissue matrix is crosslinked with a photo-activated crosslinker.
• the photo- activated crosslinker is riboflavin-5'-phosphate.
• the entire collagen-containing tissue matrix is crosslinked.
• one or more select regions of the collagen- containing tissue matrix is crosslinked.
• an array of lines and/or spots on the collagen-containing tissue matrix is crosslinked.
• the collagen-containing tissue matrix is crosslinked in a pattern.
• the pattern is selected from the group consisting of serpentine patterns, web-like patterns, circular patterns, grid patterns, linear patterns, and combinations thereof.
• Figure 1 depicts a photograph of collagen-based acellular dermal matrices (ADMs) after (1 ) treatment with 0.1 % and 1 % solutions of riboflavin-5'- phosphate, (2) vacuum drying, (3) 2 hours of UV-A crosslinking, and (4) rehydration in PBS buffer, according to certain embodiments.
• ADMs collagen-based acellular dermal matrices
• Figure 2 graphically depicts the relative effects of wet versus dry UV-A treatments on susceptibility of the collagen-based ADMs of Examples 1 , 3, and 5 and Comparative Examples 1 , 3, and 5 to in vitro collagenase digestion.
• the present disclosure provides for methods for producing a
• crosslinked tissue matrix are produced by a method comprising the steps of first (1 ) dehydrating a collagen-containing tissue matrix to form a dehydrated collagen-containing tissue matrix and then (2) irradiating the dehydrated collagen-containing tissue matrix with UV light such that at least a portion of the dehydrated collagen-containing tissue matrix is crosslinked.
• the collagen-containing tissue matrix Prior to the dehydration step (1 ), the collagen-containing tissue matrix can be impregnated with a photo-activated crosslinker.
• the crosslinked collagen-containing tissue matrix can be rehydrated with water or a pH-buffered solution, such as PBS, and subsequently sterilized.
• the crosslinked, rehydrated collagen containing tissue matrices of the present disclosure can be sterilized by exposure to gamma radiation.
• tissue matrix and "tissue matrices” refer to any human or animal tissue that contains extracellular matrix proteins.
• extracellular matrix proteins include, but are not limited to, collagens, denatured collagens, and recombinant collagens.
• the tissue matrices according to the present disclosure can comprise any type ⁇ i.e., Types I through XVIII) of collagen.
• the tissues matrices of the present disclosure comprise Type I collagen.
• the tissue matrices of the present disclosure can be of any appropriate thickness, dimension, and shape for producing a tissue product useful in regenerating, repairing, augmenting, reinforcing, and/or treating human tissues.
• thicknesses include, but are not limited to, 50 ⁇ , 100 ⁇ , 150 ⁇ , 200 ⁇ , 250 ⁇ , 300 ⁇ , 350 ⁇ , 400 ⁇ , 450 ⁇ m, 500 ⁇ , 550 ⁇ m, 600 ⁇ , 650 ⁇ m, 700 ⁇ m, 750 ⁇ , 800 ⁇ m, 850 ⁇ , 900 ⁇ m, 950 ⁇ m, 1 ,000 ⁇ , 1 ,500 ⁇ , 2,000 ⁇ m, 2,500 ⁇ m, 3,000, 3,500, 4,000, 4,500, 5,000, 5,500, 6,000, 6,500, 7,000, 7,500, 8,000, 8,500, 9,000, 9,500, 10,000, 10,500, 1 1 ,000, 1 1 ,500, 12,000, 12,500, 13,000, 13,
• the tissue matrices of the present disclosure are 200 ⁇ or greater. In other embodiments, the tissue matrices of the present disclosure are 800 ⁇ or greater. In certain embodiments, the tissue matrices of the present disclosure are in the form of a sheet.
• the tissue matrices of the present disclosure may be derived from any type of tissue.
• tissues that may be used to construct the tissue matrices of the present disclosure include, but are not limited to, skin, parts of skin ⁇ e.g., dermis), fascia, muscle (striated, smooth, or cardiac), pericardial tissue, dura, umbilical cord tissue, placental tissue, cardiac valve tissue, ligament tissue, tendon tissue, blood vessel tissue, such as arterial and venous tissue, cartilage, bone, neural connective tissue, urinary bladder tissue, ureter tissue, and intestinal tissue.
• the methods described herein can be used to crosslink any collagenous tissue type and for any tissue matrix product.
• the tissue matrices of the present disclosure include, but are not limited to, any cellularized tissue matrices, acellular tissue matrices, partially decellularized tissue matrices, decellularized tissue matrices that have been repopulated with exogenous cells ⁇ e.g., stem cells), or artificially manufactured matrices.
• decellularized products can be seeded with cells from autologous sources or other sources to facilitate treatment.
• acellular tissue matrix refers generally to any tissue matrix that is substantially free of cells and/or cellular components.
• tissue matrices of the present disclosure can be selected to provide a variety of different biological and/or mechanical properties.
• an acellular tissue matrix can be selected to allow tissue in-growth and remodeling to assist in regeneration of tissue normally found at the site where the matrix is implanted.
• an acellular tissue matrix when implanted on or into fascia or other soft tissue, may be selected to allow regeneration of the fascia or other soft tissue without excessive fibrosis or scar formation.
• tissue matrices of the present disclosure can be selected from
• ALLODERM® or STRATTICETM (LIFECELL CORPORATION, Branchburg, NJ), which are human and porcine acellular dermal matrices, respectively.
• STRATTICETM LIFECELL CORPORATION, Branchburg, NJ
• Other suitable acellular tissue matrices can be used, as described further below.
• tissue matrices of the present disclosure can be processed in a variety of ways to produce decellularized ⁇ i.e., acellular) or partially decellularized tissue matrices.
• the processing steps described below can be used along with (and either before or after) the methods described herein for producing the crosslinked tissue matrices of the present disclosure.
• decellularized or acellular tissue matrix include harvesting the tissue from a donor ⁇ e.g., a human cadaver or animal source) and cell removal under conditions that preserve biological and structural function.
• the process includes chemical treatment to stabilize the tissue and avoid biochemical and structural degradation together with or before cell removal.
• the stabilizing solution arrests and prevents osmotic, hypoxic, autolytic, and proteolytic degradation, protects against microbial contamination, and reduces mechanical damage that can occur with tissues that contain, for example, smooth muscle components ⁇ e.g., blood vessels).
• the stabilizing solution may contain an appropriate buffer, one or more antioxidants, one or more oncotic agents, one or more antibiotics, one or more protease inhibitors, and/or one or more smooth muscle relaxants.
• the tissue is then placed in a decellularization solution to remove viable cells ⁇ e.g., epithelial cells, endothelial cells, smooth muscle cells, and fibroblasts) from the structural matrix without damaging the biological and structural integrity of the collagen matrix.
• the decellularization solution may contain an appropriate buffer, salt, an antibiotic, one or more detergents, one or more agents to prevent crosslinking, one or more protease inhibitors, and/or one or more enzymes.
• Acellular tissue matrices can be tested or evaluated to determine if they are substantially free of cell and/or cellular components in a number of ways. For example, processed tissues can be inspected with light microscopy to determine if cells (live or dead) and/or cellular components remain. In addition, certain assays can be used to identify the presence of cells or cellular components. For example, DNA or other nucleic acid assays can be used to quantify remaining nuclear materials within the tissue matrices. Generally, the absence of remaining DNA or other nucleic acids will be indicative of complete decellularization ⁇ i.e., removal of cells and/or cellular components). Finally, other assays that identify cell-specific components ⁇ e.g., surface antigens) can be used to determine if the tissue matrices are acellular. After the decellularization process, the tissue sample is washed thoroughly with saline.
• an acellular tissue matrix may be made from one or more individuals of the same species as the recipient of the acellular tissue matrix graft, this is not necessarily the case.
• an acellular tissue matrix may be made from porcine tissue and implanted in a human patient.
• Species that can serve as recipients of acellular tissue matrix and donors of tissues or organs for the production of the acellular tissue matrix include, without limitation, mammals, such as humans, nonhuman primates ⁇ e.g., monkeys, baboons, or chimpanzees), pigs, cows, horses, goats, sheep, dogs, cats, rabbits, guinea pigs, gerbils, hamsters, rats, or mice.
• Elimination of the a-gal epitopes from the collagen-containing material may diminish the immune response against the collagen-containing material.
• the a- gal epitope is expressed in non-primate mammals and in New World monkeys (monkeys of South America) as well as on macromolecules such as proteoglycans of the extracellular components.
• Anti-gal antibodies are produced in humans and primates as a result of an immune response to a-gal epitope carbohydrate structures on
• the substantial elimination of a-gal epitopes from cells and from extracellular components of the collagen-containing material, and the prevention of re-expression of cellular a-gal epitopes can diminish the immune response against the collagen-containing material associated with anti-gal antibody binding to a-gal epitopes.
• the tissue sample may be subjected to one or more enzymatic treatments to remove certain immunogenic antigens, if present in the sample.
• the tissue sample may be treated with an a- galactosidase enzyme to eliminate a-gal epitopes if present in the tissue.
• the tissue sample is treated with ⁇ -galactosidase at a concentration of 300 U/L prepared in 100 imM phosphate buffer at pH 6.0. In other embodiments, the concentration of ⁇ -galactosidase is increased to 400 U/L for adequate removal of the ⁇ -gal epitopes from the harvested tissue. Any suitable enzyme concentration and buffer can be used as long as sufficient removal of antigens is achieved.
• animals that have been genetically modified to lack one or more antigenic epitopes may be selected as the tissue source.
• animals ⁇ e.g., pigs) that have been genetically engineered to lack the terminal a-galactose moiety can be selected as the tissue source.
• histocompatible, viable cells may optionally be seeded in the acellular tissue matrix to produce a graft that may be further remodeled by the host.
• histocompatible viable cells may be added to the matrices by standard in vitro cell co-culturing techniques prior to transplantation, or by in vivo repopulation following transplantation. In vivo repopulation can be by the recipient's own cells migrating into the acellular tissue matrix or by infusing or injecting cells obtained from the recipient or histocompatible cells from another donor into the acellular tissue matrix in situ.
• Various cell types can be used, including embryonic stem cells, adult stem cells ⁇ e.g., mesenchymal stem cells), and/or neuronal cells.
• the cells can be directly applied to the inner portion of the acellular tissue matrix just before or after implantation.
• the cells can be placed within the acellular tissue matrix to be implanted, and cultured prior to implantation.
• the collagen-containing tissue matrices of the present disclosure can be dehydrated in any manner to form a dehydrated collagen-containing tissue matrix.
• suitable modes of such dehydration include, but are not limited to, vacuum drying, air drying, treatment with an inert gas, dessication by hygroscopic salts, and immersion in a strongly hygroscopic fluid, such as anhydrous alcohol or glycerol.
• the collagen-containing tissue matrix can be subjected to dehydration for any time period sufficient to form a dehydrated collagen-containing tissue matrix. The length of such time periods will be dependent upon factors such as the size and thickness of the collagen-containing tissue matrix, the moisture content of the collagen-containing tissue matrix, and the temperature at which the dehydration is performed.
• the dehydration should, at minimum, be performed at a temperature below the temperature at which collagen begins to thermally denature.
• time periods include, but are not limited to, 15 minutes, 30 minutes, 1 hour, 2 hours, 3 hours, 4 hours, 5 hours, 6 hours, 7 hours, 8 hours, 9 hours, 10 hours, 1 1 hours, 12 hours, 13 hours, 14 hours, 15 hours, 16 hours, 17 hours, 18 hours, 19 hours, 20 hours, 21 hours, 22 hours, 23 hours, and 24 hours.
• the first 90% to 95% of water content in wet tissue must be removed at a
• the collagen-containing tissue matrices of the present disclosure can be dehydrated to specific depth of it thickness ⁇ i.e., partial thickness dehydration) and then subsequently irradiated with UV light to crosslink the dehydrated the collagen-containing tissue matrices.
• dehydration to a specific depth of tissue thickness can be achieved by chemical dessication.
• Treatment of only one side of a tissue sheet with a chemical dessicant removes moisture from the treated side of the sheet faster than it can be replenished via diffusion from the other ⁇ i.e., wet) side of the sheet.
• This can be done, for example, by applying glycerol to only one side of a tissue sheet.
• the side exposed to glycerol becomes translucent and dry, while the side exposed to water stays hydrated and opaque.
• This technique may be used to control or limit the effective depth of crosslinking, resulting in crosslinked collagen-containing tissue matrices according to the present disclosure having a functional gradient across their thickness or a layered or laminar structure.
• crosslinking and “crosslinked” refer to the formation of bonds between the extracellular matrix proteins of tissue matrices of the present disclosure and to extracellular matrix proteins possessing such bonds.
• bonds can be covalent bonds, electrostatic bonds ⁇ e.g., hydrogen bonds), or a combination thereof, formed between proteins of extracellular matrix. These bonds can also be the result of an atom or groups of atoms ⁇ e.g., a crosslinking agent) that is covalently or electrostatically bonded to two or more proteins of extracellular matrix.
• the dehydrated collagen-containing tissue matrix of the present disclosure can be irradiated with any wavelength of UV light sufficient to crosslink at least a portion of the dehydrated collagen-containing tissue matrix.
• the dehydrated collagen-containing tissue matrix can be irradiated with any wavelength of UV-A light, which has a wavelength in the range of from 320 to 400 nm, UV-B light, which has a wavelength in the range of from 290 to 320 nm, UV-C light, which has a wavelength in the range of from 100 of 290 nm, or any combination thereof.
• UV-A light wavelengths that can be used to irradiate the dehydrated collagen-containing tissue matrix of the present disclosure include, but are not limited to, 365 and 370 nm.
• UV-B light wavelengths that can be used to irradiate the dehydrated collagen-containing tissue matrix of the present disclosure include, but are not limited to, 250 and 265 nm.
• the dehydrated collagen-containing tissue matrix can be irradiated with UV light or, when impregnated with riboflavin-5'-phosphate as the crosslinker, electron beam radiation for any amount of time sufficient to crosslink at least a portion of the dehydrated collagen-containing tissue matrix.
• time periods include, but are not limited to, 15 minutes, 30 minutes, 45 minutes, 1 hour, 2 hours, 3 hours, 4 hours, 5 hours, 6 hours, 7 hours, 8 hours, 9 hours, and 10 hours.
• the dehydrated collagen-containing tissue matrix can also be irradiated with UV light of any intensity sufficient to crosslink at least a portion of the dehydrated collagen- containing tissue matrix, e.g., an intensity in the range of from 1 to 100 mW/cm 2 .
• intensities include, but are not limited to, 1 .0, 1 .5, 2.0, 2.5, 3.0, 3.5, 4.0, 4.5, 5.0, 5.5, 6.0, 6.5, 7.0, 7.5, 8.0, 8.5, 9.0, and 10.0 mW/cm 2 .
• the dehydrated collagen-containing tissue matrix can also be irradiated with any dosage of electron beam radiation sufficient to crosslink at least a portion of the dehydrated collagen-containing tissue matrix, e.g., a dosage in the range of from 12 to 22 kilograys (kGy).
• the UV irradiation is performed on the dehydrated collagen-containing tissue matrix continuously until the desired degree of crosslinking is achieved. In other embodiments, the UV irradiation is performed intermittently until the desired degree of crosslinking is achieved. In certain embodiments when the dehydrated collagen-containing tissue matrix is in the form of a sheet, the tissue matrix sheet is irradiated with UV on only one side of the sheet. In other embodiments, the issue matrix sheet is irradiated with UV on both sides of the sheet.
• Any source of UV light that can generate UV light at an intensity and wavelength sufficient to crosslink at least a portion of the dehydrated collagen-containing tissue matrix can be used to irradiate the dehydrated collagen-containing tissue matrix of present disclosure.
• sources include, but are not limited to, short-wave UV lamps, UV gas-discharge lamps, UV light-emitting diodes (LEDs), and UV lasers.
• An example of an UV crosslink chamber that can be used to irradiate and crosslink the dehydrated collagen-containing tissue matrix of present disclosure is the Stratalinker 2400TM (Stratagene). As with dehydration, the temperature during UV irradiation should not exceed 40 °C.
• the entire dehydrated collagen-containing tissue matrix can be irradiated with UV light in accordance with the method of the present disclosure in order to crosslink at least a portion of the dehydrated collagen-containing tissue matrix. It is known that crosslinking can increase the resistance of tissue matrices to enzymatic degradation by inflammatory cells within the body and such increased resistance can slow the rate of weakening after implantation. However, excessive crosslinking can have adverse effects on cell infiltration and regeneration of normal tissue within the tissue matrix.
• tissue matrices may be used for a variety of other reasons. For example, it can allow production of differing strength or other mechanical properties treating the tissue to make native stronger.
• production of tissue matrices with localized pliability may allow a surgeon to place tissue in small openings, including passing a tissue matrix through a laparoscopic incision or trocar.
• production of tissue with localized pliability can be beneficial to allow matching of compliances with natural tissues or to match anisotropic mechanical properties of tissues.
• Localized crosslinking of the dehydrated collagen-containing tissue matrices can be achieved by irradiating the tissue matrix through a mask so as to result in an array or pattern of crosslinked lines and or spots in the tissue matrix.
• the collagen-containing tissue matrices of the present disclosure can be impregnated with photo-activated crosslinker(s).
• the photo-activated crosslinker or crosslinkers are non-cytotoxic and/or do not release cytotoxic residuals upon degradation of the collagen-containing tissue matrix.
• non-cytotoxic, photo-activated crosslinkers examples include, but are not limited to, riboflavin-5'-phosphate and salts thereof, Rose Bengal, bioflavonoids, ascorbic acid and salts thereof, and any combination thereof.
• specific bioflavonoids examples include, but are not limited to, proanthocyanidin, catechin, epicatechin, epigallo catechin, epicatechin gallate, epigallocatechin gallate, quercetin, tannic acid, and combinations thereof.
• ascorbic acid and salts thereof can also act as a radioprotectant ⁇ i.e., provides protection from long term oxidative degradation via free radical scavenging).
• the collagen-containing tissue matrices of the present disclosure can be impregnated with a mixture of riboflavin and ascorbic acid.
• the collagen-containing tissue matrices of the present disclosure can be impregnated with the photo-activated crosslinker or crosslinkers in a number of ways.
• the collagen-containing tissue matrices of the present disclosure are impregnated with the photo-activated crosslinker or crosslinkers by soaking it in a solution of the photo-activated crosslinker or crosslinkers.
• the solvent of the solutions of photo-activated crosslinker or crosslinkers can be any suitable biocompatible solvent.
• An example of such biocompatible solvents includes, but is not limited to, water.
• the solutions of photo- activated crosslinker or crosslinkers can further comprise any suitable
• the photo-activated crosslinker or crosslinkers can be formulated in pH-buffered solutions, both aqueous and nonaqueous.
• pH-buffered solutions include, but is not limited to, phosphate-buffered saline (PBS) and aqueous buffering systems based on citrate, acetate, and HEPES.
• PBS phosphate-buffered saline
• HEPES aqueous buffering systems based on citrate, acetate, and HEPES.
• the photo-activated crosslinker or crosslinkers can be formulated in an unbuffered saline solution.
• the photo-activated crosslinker or crosslinkers solutions with which the collagen-containing tissue matrices of the present disclosure may be impregnated can have any suitable concentration of crosslinker.
• the concentration can be in the range of from 0.01 % to 5.0% or in the range of from 0.1 % to 1 .0%. Examples of specific concentrations include, but are not limited to, 0.01 %, 0.02%, 0.03%, 0.04%, 0.05%, 0.06%, 0.07%, 0.08%, 0.09%, 0.1 %, 0.2%, 0.3%, 0.4%, 0.5%, 0.6%, 0.7%, 0.8%, 0.9%, 1 .0%, 1 .5%, 2.0%, 2.5%, 3.0%, 3.5%, 4.0%, 4.5%, and 5.0%.
• the present disclosure also provides for crosslinked tissue matrices produced by the foregoing methods.
• These crosslinked tissue matrices can be used to produce tissue products for treating patients.
• tissue products are available for regeneration, repair, augmentation, reinforcement, and/or treatment of human tissues that have been damaged or lost due to various diseases and/or structural damage ⁇ e.g., from trauma, surgery, atrophy, and/or long-term wear and degeneration).
• Such products can include, for example, acellular tissue matrices, tissue allografts or xenografts, and/or reconstituted tissues ⁇ i.e., at least partially decellularized tissues that have been seeded with cells to produce viable materials).
• Tissue products produced from the crosslinked tissue matrices of the present disclosure may be used to repair defects ⁇ e.g., hernias), to support surrounding tissues or implants ⁇ e.g., for breast augmentation and/or reconstruction), or to replace damaged or lost tissue ⁇ e.g., after trauma or surgical resection).
• the crosslinked tissue matrices of the present disclosure can be used to construct a hernia repair mesh, which can be used to repair abdominal wall hernias.
• the tissue product is a collagen sponge.
• the tissue product is an injectable collagen formulation, such as an injectable adipose tissue matrix.
• the tissue product should be sufficiently resistant to enzymatic degradation until tissue regeneration and/or repair occurs.
• the tissue products of the present disclosure can also comprise an acellular, collagen-containing tissue matrix, wherein the tissue matrix is a flexible sheet having a thickness of greater than 200 ⁇ , e.g., greater than 800 ⁇ or at least 5,000 ⁇ ⁇ i.e., 5 mm), wherein the tissue matrix is cross-linked to a depth of greater than 200 ⁇ from a surface of the tissue matrix, and wherein the tissue matrix is free of cytotoxic residues, such as those that would result from the use of certain chemical crosslinkers.
• the tissue product is a collagen sponge
• the collagen sponge can have a thickness of up to 50,000 ⁇ ⁇ i.e., 5 cm).
• the tissue matrix can be crosslinked across its full thickness.
• the collagen- containing tissue matrix can be derived from any of the sources described above and can be crosslinked with any of the photo-activated crosslinkers described above.
• the entire collagen-containing tissue matrix can be crosslinked or only one or more select regions thereof, as described above.
• a 2 cm x 3 cm sample of sheet acellular dermal matrix (ADM) derived from porcine dermis and having a wet thickness of approximately 1 .3 mm was vacuum dried at 35 °C at less than 100 millitorr absolute pressure for 12-24 hours, yielding a dried, semi-transparent ADM having a thickness of approximately 0.7 mm.
• the dried, semi-transparent ADM was then transferred to a UVP model CL-1000 ultraviolet crosslinker using UVA lamps emitting a UV wavelength in the range of from 350-375 nm (target 365 nm) and irradiated with 370 nm wavelength UV-A light at an intensity of 5.5 mW/cm 2 for 2 hours .
• the ADM was then rehydrated overnight in Dulbecco's phosphate-buffered saline (PBS buffer) with no Ca or Mg salts
• a 2 cm x 3 cm sample of "wet” ⁇ i.e., not vacuum dried overnight) sheet acellular dermal matrix (ADM) derived from porcine dermis and having a wet thickness of approximately 1 .3 mm was placed in a UVP model CL-1000 ultraviolet crosslinker using UVA lamps emitting a UV wavelength in the range of from 350-375 nm (target 365 nm) and irradiated with 370 nm wavelength UV-A light at an intensity of 5.5 mW/cm 2 for 2 hours.
• UVADM acellular dermal matrix
• a 2 cm x 3 cm sample of sheet acellular dermal matrix (ADM) derived from porcine dermis and having a wet thickness of approximately 1 .3 mm was vacuum dried at 35 °C at less than 100 millitorr absolute pressure for 12-24 hours, yielding a dried, semi-transparent ADM having a thickness of approximately 0.7 mm.
• the dried, semi-transparent ADM was then transferred to a UVP model CL-1000 ultraviolet crosslinker using UVA lamps emitting a UV wavelength in the range of from 350-375 nm (target 365 nm) and irradiated with 370 nm wavelength UV-A light at an intensity of 5.5 mW/cm 2 for 4 hours.
• the ADM was then rehydrated overnight in Dulbecco's phosphate-buffered saline (PBS buffer) with no Ca or Mg salts
• a 2 cm x 3 cm sample of "wet” ⁇ i.e., not vacuum dried overnight) sheet acellular dermal matrix (ADM) derived from porcine dermis and having a wet thickness of approximately 1 .3 mm was placed in a UVP model CL-1000 ultraviolet crosslinker using UVA lamps emitting a UV wavelength in the range of from 350-375 nm (target 365 nm) and irradiated with 370 nm wavelength UV-A light at an intensity of 5.5 mW/cm 2 for 4 hours.
• UVP model CL-1000 ultraviolet crosslinker using UVA lamps emitting a UV wavelength in the range of from 350-375 nm (target 365 nm) and irradiated with 370 nm wavelength UV-A light at an intensity of 5.5 mW/cm 2 for 4 hours.
• a 2 cm x 3 cm sample of sheet acellular dermal matrix (ADM) derived from porcine dermis and having a wet thickness of approximately 1 .3 mm was soaked for up to 20 hours in a 0.1 % by weight solution of riboflavin-5'-phosphate in PBS buffer ( Figure 1 a).
• the riboflavin-treated ADM was then vacuum dried at 35 °C at less than 100 millitorr absolute pressure for 12-24 hours, yielding a dried, semi- transparent ADM ( Figure 1 b) having a thickness of approximately 0.7 mm.
• the dried, semi-transparent ADM was then transferred to a UVP model CL-1000 ultraviolet crosslinker using UVA lamps emitting a UV wavelength in the range of from 350-375 nm (target 365 nm) and irradiated with 370 nm wavelength UV-A light at an intensity of 5.5 mW/cm 2 for 2 hours ( Figure 1 c).
• the ADM was then rehydrated overnight in Dulbecco's phosphate-buffered saline (PBS buffer) with no Ca or Mg salts (standard nominal concentration of 2.67 imM KCI, 1 .47 imM KH 2 PO 4 , 138 imM NaCI, and 8.06 mM Na 2 HPO 4 -7H 2 O) (Figure 1 d).
• PBS buffer Dulbecco's phosphate-buffered saline
• Ca or Mg salts standard nominal concentration of 2.67 imM KCI, 1 .47 imM KH 2 PO 4 , 138 imM NaCI, and
• a 2 cm x 3 cm sample of "wet" ⁇ i.e., not vacuum dried overnight) sheet acellular dermal matrix (ADM) derived from porcine dermis and having a wet thickness of approximately 1 .3 mm was soaked for up to 20 hours in a 0.1 % by weight solution of riboflavin-5'-phosphate in PBS buffer.
• the riboflavin-treated ADM was then placed in a UVP model CL-1000 ultraviolet crosslinker using UVA lamps emitting a UV wavelength in the range of from 350-375 nm (target 365 nm) and irradiated with 370 nm wavelength UV-A light at an intensity of 5.5 mW/cm 2 for 2 hours.
• a 2 cm x 3 cm sample of sheet acellular dermal matrix (ADM) derived from porcine dermis and having a wet thickness of approximately 1 .3 mm was soaked for up to 20 hours in a 0.1 % by weight solution of riboflavin-5'-phosphate in PBS buffer.
• the riboflavin-treated ADM was then vacuum dried at 35 °C at less than 100 millitorr absolute pressure for 12-24 hours, yielding a dried, semi-transparent ADM having a thickness of approximately 0.7 mm.
• the dried, semi-transparent ADM was then transferred to a UVP model CL-1000 ultraviolet crosslinker using UVA lamps emitting a UV wavelength in the range of from 350-375 nm (target 365 nm) and irradiated with 370 nm wavelength UV-A light at an intensity of 5.5 mW/cm 2 for 4 hours.
• the ADM was then rehydrated overnight in Dulbecco's phosphate-buffered saline (PBS buffer) with no Ca or Mg salts (standard nominal concentration of 2.67 mM KCI, 1 .47 mM KH 2 PO 4 , 138 mM NaCI, and 8.06 mM Na 2 HPO 4 -7H 2 O).
• a 2 cm x 3 cm sample of "wet" ⁇ i.e., not vacuum dried overnight) sheet acellular dermal matrix (ADM) derived from porcine dermis and having a wet thickness of approximately 1 .3 mm was soaked for up to 20 hours in a 0.1 % by weight solution of riboflavin-5'-phosphate in PBS buffer.
• the riboflavin-treated ADM was then placed in a UVP model CL-1000 ultraviolet crosslinker using UVA lamps emitting a UV wavelength in the range of from 350-375 nm (target 365 nm) and irradiated with 370 nm wavelength UV-A light at an intensity of 5.5 mW/cm 2 for 4 hours.
• a 2 cm x 3 cm sample of sheet acellular dermal matrix (ADM) derived from porcine dermis and having a wet thickness of approximately 1 .3 mm was soaked for up to 20 hours in a 1 .0 % by weight solution of riboflavin-5'-phosphate in PBS buffer ( Figure 1 a).
• the riboflavin-treated ADM was then vacuum dried at 35 °C at less than 100 millitorr absolute pressure for 12-24 hours, yielding a dried, semi- transparent ADM ( Figure 1 b) having a thickness of approximately 0.7 mm.
• the dried, semi-transparent ADM was then transferred to a UVP model CL-1000 ultraviolet crosslinker using UVA lamps emitting a UV wavelength in the range of from 350-375 nm (target 365 nm) and irradiated with 370 nm wavelength UV-A light at an intensity of 5.5 mW/cm 2 for 2 hours ( Figure 1 c).
• the ADM was then rehydrated overnight in Dulbecco's phosphate-buffered saline (PBS buffer) with no Ca or Mg salts (standard nominal concentration of 2.67 imM KCI, 1 .47 imM KH 2 PO 4 , 138 imM NaCI, and 8.06 mM Na 2 HPO 4 -7H 2 O) (Figure 1 d).
• PBS buffer Dulbecco's phosphate-buffered saline
• Ca or Mg salts standard nominal concentration of 2.67 imM KCI, 1 .47 imM KH 2 PO 4 , 138 imM NaCI, and
• a 2 cm x 3 cm sample of "wet" (i.e., not vacuum dried overnight) sheet acellular dermal matrix (ADM) derived from porcine dermis and having a wet thickness of approximately 1 .3 mm was soaked for up to 20 hours in a 1 .0 % by weight solution of riboflavin-5'-phosphate in PBS buffer.
• the riboflavin-treated ADM was then placed in a UVP model CL-1000 ultraviolet crosslinker using UVA lamps emitting a UV wavelength in the range of from 350-375 nm (target 365 nm) and irradiated with 370 nm wavelength UV-A light at an intensity of 5.5 mW/cm 2 for 2 hours.
• a 2 cm x 3 cm sample of sheet acellular dermal matrix (ADM) derived from porcine dermis and having a wet thickness of approximately 1 .3 mm was soaked for up to 20 hours in a 1 .0 % by weight solution of riboflavin-5'-phosphate in PBS buffer.
• the riboflavin-treated ADM was then vacuum dried at 35 °C at less than 100 millitorr absolute pressure for 12-24 hours, yielding a dried, semi-transparent ADM having a thickness of approximately 0.7 mm.
• the dried, semi-transparent ADM was then transferred to a UVP model CL-1000 ultraviolet crosslinker using UVA lamps emitting a UV wavelength in the range of from 350-375 nm (target 365 nm) and irradiated with 370 nm wavelength UV-A light at an intensity of 5.5 mW/cm 2 for 4 hours.
• the ADM was then rehydrated overnight in Dulbecco's phosphate-buffered saline (PBS buffer) with no Ca or Mg salts (standard nominal concentration of 2.67 mM KCI, 1 .47 mM KH 2 PO 4 , 138 mM NaCI, and 8.06 mM Na 2 HPO 4 -7H 2 O) .
• PBS buffer Dulbecco's phosphate-buffered saline
• Ca or Mg salts standard nominal concentration of 2.67 mM KCI, 1 .47 mM KH 2 PO 4 , 138 mM NaCI, and 8.06
• a 2 cm x 3 cm sample of "wet" (i.e., not vacuum dried overnight) sheet acellular dermal matrix (ADM) derived from porcine dermis and having a wet thickness of approximately 1 .3 mm was soaked for up to 20 hours in a 1 .0 % by weight solution of riboflavin-5'-phosphate in PBS buffer.
• the riboflavin-treated ADM was then placed in a UVP model CL-1000 ultraviolet crosslinker using UVA lamps emitting a UV wavelength in the range of from 350-375 nm (target 365 nm)and irradiated with 370 nm wavelength UV-A light at an intensity of 5.5 mW/cm 2 for 4 hours.
• Examples 1 -6, Comparative Examples 1 -6, and the Control Example were each analyzed by DSC to determine the effect that drying the samples prior to UV irradiation has on the thermal denaturation of the ADMs.
• a higher onset temperature of collagen thermal denaturation was observed for Examples 1 -6 (dried samples prior to UV irradiation) compared to each of their respective counterparts of Comparative Examples 1 -6.
• the higher thermal onset temperatures for the dried samples indicates a lack of denaturation compared to samples that were irradiated when fully hydrated.
• Control Example were each subjected to in vitro collagenase digestion to determine the effect drying prior to UV irradiation has on the degree to which collagenase digests the collagen of the ADMs over a given time period.
• a higher degree of collagenase resistance was observed for Examples 1 , 3, and 5 compared to each of their respective counterparts

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